House – Episode 7 (Season Three): “Son of Coma Guy”
Despite the presence of John Larroquette, this is a confused mish-mash of an episode with poorly thought out medicine and unexciting soap opera. Still, it was better than an episode of Manimal. There are spoilers in the medical review of House below, so consider yourself warned.
House is eating lunch and watching television in a ward dedicated to patients in a persistent vegetative state when Kyle, the son of one of the patients, comes in to visit his father. House has noticed that Kyle has akinetopsia, an inability to detect objects in motion. House mentions that people with intermittent akinetopsia like Kyle often have seizures as well, and he flicks the lights on and off to see if he can induce a seizure. He does — Kyle has a generalized seizure and ends up admitted to House’s service. The team discovers that he’s had seizures before, and has had them worked-up but the tests have always been negative. They also discover that he’s an alcoholic.
The initial differential diagnosis of Kyle’s seizures includes infection, brain tumor, or trauma. House suspects Kyle might have an inherited disease. He has the team test for adrenomyeloneuropathy, but the tests come back negative. He then wants to test for Unverricht-Lundborg Disease and Late-Onset Lafora’s. These are all rare inherited diseases that have seizures as symptoms.
While being interviewed, Kyle complains of nausea. On exam, he shows right upper quadrant abdominal tenderness and begins to cough up blood. Foreman order an immediate transfusion. He is noted to be slipping into a coma and is a “4 on the RLAS scale” (The Rancho Los Amigos Scale is a scale used to assess the severity of head trauma and coma patients. By the way, you’ll notice the S stands for “scale” so “RLAS scale” is redundant, but the characters said it that way so I’ll stick with it.). His kidneys are soon failing as well and he is started on dialysis.
House decides the only way to get information about Kyle is to wake up his father who has been in the persistent vegetative state for ten years. Using a combination of L-dopa (the drug used by the doctor in Awakenings), amphetamines, a secret South American African drug, and eleven herbs and spices, House manages to wake Kyle’s father Gabriel.
Gabriel understands the medications are only temporary, and in twenty-four hours or so he will slip back into his vegetative state for good. He lets House know that he’ll only answer his questions if House will take him to get a hoagie at his favorite sandwich shop in Atlantic City. House, Gabriel, and Wilson all pile into Wilson’s car and take a road trip to Atlantic City. When they can’t find the sub shop, they end up sharing a hotel room at a casino. Gabriel tells House know that for each question he answers for House, House has to answer one for him. What follows is an exchange of personal and family history — medical and otherwise — with occasional interjections from Wilson.
Back at the hospital, Kyle is getting worse; he’s now a 3 on the RLAS scale. After talking with his father, House decides that Kyle may have mercury poisoning from exposures at his father’s factory years ago. He is started on chelation therapy to remove the mercury, but his labs show no evidence of mercury so that diagnosis is wrong. Kyle’s blood pressure and oxygen saturation drop. His heart rhythm is abnormally fast so he is given an injection of epinephrine. An echocardiogram is attempted, but he has another seizure while undergoing the procedure. He then has another episode of an irregular heart rhythm and requires defibrillation. House calls Foreman and announces that he has diagnosed Kyle with Red Ragged Fiber disease. (Red Ragged Fiber disease is a mitochondrial disease; these are inherited maternally because the abnormal mitochondria are passed from the mother to her offspring by the mitochondria in the mother’s eggs.) Foreman tells House that it’s too late; Kyle has severe alcoholic cardiomyopathy and a transplant is his only hope of survival, but none are available.
Gabriel offers Kyle his heart, but Cuddy refuses pointing out that Gabriel is still alive. House asks Wilson to leave the room. After a brief discussion with Gabriel, he too steps out of the room. They hear a loud thud from within the hotel room. Gabriel has committed suicide so that his son can have his heart.
The medicine was poor and scattershot this week. I know this was intended as a “chew the scenery” episode and not a medical episode, but I still expected better. First, why was Kyle admitted to House’s service? He had a seizure — nothing too mysterious about that (and it takes more flickering than that to induce a seizure in people who have photosensitive epilepsy). Then this young patient instantly goes into severe liver and kidney failure. Sure, he’s an alcoholic, but that’s still mighty fast. Then we’re told “forget the liver and kidneys, it’s his heart.” He might have alcoholic cardiomyopathy, but clearly he also has kidney disease or he wouldn’t have been placed on dialysis. And the right upper quadrant pain and vomiting blood are vastly more consistent with liver disease than cardiomyopathy. This raises the question whether he would be candidate at all for heart transplant since his kidneys and liver are still in such bad shape. Finally, the Myoclonic Epilepsy with Ragged-Red Fibers diagnosis doesn’t really fit the situation well, and even if it did, it has a generally poor outcome and would be another reason not to perform the transplant.
In terms of Gabriel, it was convenient a mysterious “South American African paper” led House to his wake-up-the-vegetative-patient medication. They refer to Awakenings in the episode, both by name and action, but despite what the writers imply, it’s apples and oranges. Oliver Sacks was dealing with patients with a rare neurological condition, whereas Gabriel has brain damage brought on by lack of oxygen. Two completely different situations and no wonder drug is going to wake up a brain damaged patient. It was amazing Gabriel had such great muscle tone and no problems speaking after ten years in a vegetative state, wasn’t it? And I sure hope he has a compatible blood type with his son, or that heart he killed himself for is going to go to waste.
The sad part is that with all the bad medicine, the soap opera was only fair. Despite the best efforts of John Larroquette and Hugh Laurie, the hotel room scenes just didn’t seem believable. Wilson did better with his scenes, but he didn’t get all that much. Meanwhile the cop talked up all three of the Young Guns back at the hospital. All three acted as you’d expect, so no surprise there, except that all three told House about it, which was more than I expected.
This episode earns a C for the mystery (and its a mystery why it’s a mystery) and a B for the solution (the use of a mitochondrial disease is clever). The medicine, however, gets a dismal D, and the soap opera only receives a C- (partially salvaged by Wilson and the Young Guns).
The previous House review
A list of all prior House reviews
November 15th, 2006 at 12:01 am
A minor point, I thought it was a South African paper/medicine, not South American.
I thought the soap opera scenes were alright, as they highlighted the tension that’s arising between House and Wilson.
To borrow a quote from the cartoon show “The Critic”, this episode seemed to be full of fantasy and crap. Clearly a patient isn’t going to be that lucid and dexterous (able to drive a car for long distances even!) that quickly after being on his back for 10 years.
Ignoring this, I thought the soap opera elements were fairly well done. John Larroquette did an excellent job I thought, presenting a stubborn yet likable character that knows his time is about to expire. A patient that actually negotiates with House instead of just caving in to him. David Morse continued to do an excellent job imo (every scene he was in, or ever scene where I THOUGHT he was going to be in, I got a really uncomfortable feeling in my stomach, which is exactly what I should have been feeling). The inquiries of House were interesting at the very least.
November 15th, 2006 at 12:24 am
I thought this was one the better episodes so far this season. The medicine may have been horrible, but it was hilarious and very well acted, even if it wasn’t really believable (I don’t think believability was a top priority in this episode). John Larroquette and the guy who played his son were both great, especially Larroquette. Wilson was very good as well. It is always refreshing when he is brought into the spotlight.
I also enjoyed the minor modifications to the show’s formula. For example, the case was introduced in a more interesting way than usual (though you are right that it doesn’t make sense that House would be on the kid’s case), and the little road trip was nice. I am enjoying the long story arcs as well. It’s a very welcome addition to the show.
November 15th, 2006 at 12:41 am
House takes cases that interest him, so I don’t know why it’s hard to believe he’d take the case. It’s ‘Son of Coma Guy’. And I loved Larroquette.. this was honestly one of my favorites, despite the medicine being ridiculous.
November 15th, 2006 at 12:50 am
I really thought that Chase was going to sell House out.
November 15th, 2006 at 1:27 am
To echo earlier sentiments, I thought this week’s “soap opera” elements were leaps and bounds better than those of other episodes in this season. Much of the original wit absent in previous episodes resurfaced in House’s conversations with Gabe. The acting was still very revealing even if the hotel room seemed a bit… anachronistic (especially with the hoagie).
I also like the parallel to Les Miserables with Morse’s character and House, both utterly committed to very similar personal philosophies. But the writers have added a lot more complexity. After all, House is far more controversial than the impeccable Valjean.
Plus, the moment of confusion when Wilson is in the casino manipulating that woman was great.
November 15th, 2006 at 2:51 am
I think this was one of the best HOUSE episodes of the season.
We learn something more about House and there’s a lot going on
between Wilson and House. What more do you want?
I’ll give it an A.
November 15th, 2006 at 2:58 am
I think that besides the bath medicine, what bothers me the most is this Michael Tritter arc, and how little it’s doing for me. I found myself wanting to just fast-forward during all the interrogation scenes, which were, as you said, predictable. Mostly I’m just pissed because I absolutely love David Morse, but feel this character is just not getting enough depth put into it. “Everyone lies” indeed. Apparently it’s only an interesting character turn-about when they start to resemble House.
Still, I almost liked everything else. Wilson was great, and I loved Cuddy’s overwhelmed response at the end. Also, I found it a little strange how little attention they put to the melodrama of assisting in the man’s suicide, style wise. I liked it, as opposed to the music montages of previous seasons that would have totally made twenty minutes of this guy’s end. Refreshing, though I’m not sure it’s more than that.
November 15th, 2006 at 4:36 am
This episode left a bad taste in my mouth, for reasons you’ve already cited. Perhaps some people thought the soap opera aspect was good, but I started watching this show because of the medical mysteries and unconventional characters, not because I wanted to see a fantastical buddy movie featuring an awakened coma guy and a cantankerous doctor. (Since when did this show turn into a barrel full of angst and decide to regularly include dime-store psychobabble?)
The medicine was abysmal and distracted me from any appreciation I might have for the soap opera. Really, everything the character House does is related to medicine, so even the soap opera part of the show was entangled in the overarching issue – a soap opera that ended in a pseudo-assisted suicide was still ultimately about the medicine. And it was far-fetched as hell.
Very weak show. I gave it an F.
November 15th, 2006 at 6:37 am
I love this show despite its inaccuracies. I thought last night’s episode was quite good. I loved seeing the friendship between Wilson and House which showcases Houses’s decency. I also loved the reveal about how House met Stacy which had never been disclosed before.
P.S. I think this website is well done!
November 15th, 2006 at 6:56 am
I think the relationship between characters has evolved in this chapter. I agree that Wilson and Larroquette had a really good performance.
But I can find a severely incoherent sign on the plot. If the final diagnose is Rugged Red Fiber Cells illness, and it’s transmitted by the mother, why did the father present akinetopsia as well? He clearly was unable to catch a soda thrown by Wilson, just as his son couldn’t catch the chips packet. And this was the only sign of brain damage we could see in him (he could drive, speak, walk, and so on). Also, ridiculous the “Awakening” with L-dopa, as long as they wasn’t talking about any type of parkinsonism nor about encephalitis lethargica.
November 15th, 2006 at 7:05 am
The awakening stuff comes largely from South AFRICAN (not American) media reports like these:
http://www.guardian.co.uk/medicine/story/0,,1870279,00.html
http://www.dailymail.co.uk/pages/live/articles/news/news.html?in_article_id=404832&in_page_id=1770
I’m sure you can call shenanigans on this (and the drug they used was Zolpidem (Ambien), a simple sleeping pill), I’m certainly not qualified to expound on the likelihood of this course of treatment actually working. There are a few short explanations of how it’s supposed to work, something about GABA inhibiting (apparently in PVS one is GABA hypersensitive or something) by binding to the BZ1 receptors…I dunno, it all sounds unlikely to work on a large scale to me, but who knows.
And I recently watched a program on Discovery Health about people who awake from long bouts in COMA, vegetative states, and so on — and yes, they don’t simply awaken with a hankering for steak. They usually have slurred speech, poor motor control, general disorientation and extreme muscle atrophy. At least that’s what the TV told me ;-)
November 15th, 2006 at 7:35 am
Unless the writing of this show improves greatly in the next few episodes, I’m not going to bother watching it anymore. The reasons?
1. Everything has gone completely beyond even the most liberal boundaries of reality:
a. a hospital MD injects a vegetative patient with a hand-mixed “deus ex-machina” cocktail;
b. The patient, in a PVS for 10 years just pops right up and starts dancing, practically;
c. The MD doesn’t catch any real flack from hospital administration;
d. the same MD purposefully induces seizures in another patient, because it’s cool (!!), and doesn’t get sued, or even a complaint.
e. 2 MDs on staff just take off with the newly awakened VGS patient (don’t they have work to do? Isn’t there some hospital policy about taking patients on road trips?)
f. 2 MDs sit outside a hotel room while said patient hangs himself!
g. Hanged man’s body is rushed back to save son. Isn’t there some, I don’t know, *law* about the handling of dead bodies, and who might or might not get the heart? I don’t think that an alcoholic would even automatically qualify to get his father’s heart, if there were others in the line ahead of him for transplants.
Forget about all the cop stuff, which has gotten ridiculous – I think any good lawyer could have gotten that investigation quelled by now for various reasons.
The writing this season is desultory, at best. Cutty has been reduced to a standing joke. The young guns are rude mechanicals, going through the motions to make it look like the story is actually happing in a hospital. The medicine is freakish.
When I watch the show this season I feel like it was written by a food processor. Mish-mash indeed.
November 15th, 2006 at 8:32 am
I like your reviews – It’s good to see how the medicine in the show compares to Real Life(tm).
This episode was quite good, I reckon. It had some very revealing scenes, as a previous commenter said, and really showed the relationship between Wilson and House. So the medicine is off – I don’t mind that too much, as the show is more for the character of House, than for proper medicine.
House’s comments, while obviously very crude and rude, sometimes really give an insight to the situation that would otherwise not be obvious. Some very Sherlock-like features in this episode. The Three Ducklings do seem to be just filling roles at times.
The cop arc is interesting, but does seem drawn out to allow it to go side-by-side with the patient and other soap aspects.
One more thing I need to say: The cop asks “What has House done to deserve Cameron’s loyalty?”. He might be an addict, rude, arrogant, and, well, House. But he does have a singular goal: solve the puzzle, save the patient. He puts his life aside to save people he doesn’t know. It might just be for the puzzle… but, ep 109 – DNR has things to say about that.
November 15th, 2006 at 9:03 am
What happened to the storyline involving Foreman and his nurse love-interest?
November 15th, 2006 at 10:06 am
Isabel: I think the father failed to catch the soda can because the meds given to him were starting to wear off.
I think the episode was pretty good since it does give us a bit more insight about House. I too was wondering why he chose to become a doctor, and that question was finally answered to some extent.
November 15th, 2006 at 10:14 am
Wow. Opinions fit a bimodal distribution perfectly! I am in the center toward the + side. I can excuse the poor medicine and less developed good areas because the good parts were new and done pretty well. I really liked House’s answer to why he became a doctor. His character seems to me to be an extreme example of a part of all of us. In the show he gets away with stuff we would love to get away with, but the real world tells us – no, you are wrong! He sees the world in brutal honest reality, but that, of course, is policically wrong. This seems to be the main theme to me. The specifics of each episode are not too important to me. The overall entertainment is a nice escape from reality. And where is that young girl?…
November 15th, 2006 at 10:25 am
The medicine was part. The drama was sub-par.
I fail to understand why the show has taken the turn to euthanasia and assisted suicide. It’s not the same show anymore.
November 15th, 2006 at 10:55 am
I really don’t like the cop storyline, personally. It seems fairly obvious that House isn’t going to be locked up for 10+ years like he deserves, because then there wouldn’t be a show. So he’s obviously going to get out of it somehow, and a conflict that doesn’t really exist just annoys me.
November 15th, 2006 at 12:02 pm
I agree 100% with what keith says. Keep up the good work Keith, your my hero and savior.
November 15th, 2006 at 12:23 pm
The cop storyline is stupid. Saying to a cop that the prescriptions he shows you were signed by you means absoluetly nothing. Anyone is allowed to remain silent during an investigation and obstruction of justice by lying can only be proven if you can prove the person inrtentionally lied and there is no way anyone can prove that Wilson didn’t truly believe that the signatures were his. He’s not an expert in handwriting, he’s a doctor that is busy and saw a signature that looked like his. Not exactly a provable lie. I also think its funny that Wilson had his accounts frozen??? Who is Wilson in this investigation? If anything he is a victim, not a criminal? He only lied if you could prove he inteionally lied, which you can’t (and there is certainly no way, shy of an admission, to prove his was in on any of this). This cop is barking up the worng tree. Its stupid. I never thought there would be someone on this show that needs to get laid more than House, but they found one.
November 15th, 2006 at 1:08 pm
They are showing Tritter, the cop, to be as relentless as House is. Going after Wilson to get to House is something House would do, only House does things like that for his patients, Tritter is just out for revenge.
I thought the medicine this week was bad, and I have no medical background. The soap opera side wsa good, but not quite good enough to justify such gimmicks as “the shot that wakes the patient out of a persistent vegetative state, but only for 25 hours”.
November 15th, 2006 at 2:47 pm
Since I don’t know anything about medicine I can only appreciate the soap aspect of the show but it was really good! It was really moving that the father would choose to give up his heart so that his son has a chance. The only part I don’t like is House not telling the son what the dad did to save him. C’mon, he needs closure too!!!
As for the cop storyline, frankly, I think they plan on bringing Stacey back into the show. House/Wilson doesn’t belong to primetime yet!
November 15th, 2006 at 3:22 pm
Melanie Santos – Where did House meet Stacy? I know that Gabe asked if House fell in love, but I don’t remember House going into details…
November 15th, 2006 at 3:26 pm
I’d say while judging the medical side of House is a fairly objective thing (it’s either really plausible, believable, a strech or just bullsh*t and correctly/believably/incorrectly displayed), judging the drama is definitly way more subjective.
What I can say is that in this week’s episode the interaction between House and Wilson was very revealing and exceptionally well acted. This episode’s drama also probes more deeply House’s ethics, values and personal feelings for his friend than any other before. We always knew he’d go to great lenghts to solve a puzzle and save a life. But this time it was different. Through the question-game a level of intimacy between House and a patient was achieved that is unprecidented in the series. He told Gabriel things he would probably tell nobody else with the possible exception of Wilson (as part of a deal, I know, but House knew what he was in for, too. And I think he only agreed to spilling his innermost secrets because 1. He could see eye to eye with Gabriel and 2. He knew he wasn’t going to be around for very long so he didn’t need to worry about anybody running around who truly knows his motivations and his feelings except for Wilson, who is probably the only person he really trusts… and I’m not sure House didn’t tell Gabriel things even Wilson didn’t know before then.)
House’s character seems to me to be such that not only does he need to solve the most difficult riddles he can find (”rubik’s complex”) so as to vaildate himself – to himself (and after this episode I’m fairly certain: towards his father in absentia); He also needs to be intransparent to others. While occasionally he opened himself up just a tiny bit towards patients (e.g. Pilot) – but he never let anybody get as deep as Gabriel (as I said except for Wilson… and again as I said, I think with the help of the question-game he could reveal things to Wilson he couldn’t otherwise.)
Then there’s the topic of ethics. We know that House doesn’t mind assisted suicide in the case of a fatal illness where the rest of the patient’s life would consist of immense pain (Informed Consent), this was a first, too.
The hotel room scene from the point when House talked to Cuddy was one of the most powerful in the entire series (IMO). Why? Let me elaborate:
There are only two ways to really get to know what a person’s ethical world-view is, what his moral foundation is… through philosophical discourse about Ethics (I’m a Philosophy-Major btw) and in cases where these (values and ethical world-view) are pushed to the limit.
This was the case here. His “leave the room” and “Maybe I don’t want to push this ’till it breaks” (we didn’t know how far he would really go and if he wouldn’t really do that up until now) to Wilson and the way he handled Gabriel’s request were immensly revealing, extremely well acted IMO and well-written.
Of course I just love the Tritter-arc. Tense, well written and acted. House and Tritter are alike in many ways (noone seems to be able to intimidate them, extremely stubborn, not really well-adjusted, intelligent, devious, committed etc.), still their motivations and goals are different… The interplay is almost like a Fugue by Bach, point and counterpoint… very interesting.
I’m sorry for the lenght… but since Scott (I agree with his reviews in about 88% of the episodes) and many others seem to feel the drama was lame or poor here, I felt I needed to justify my position. Hope you didn’t mind.
November 15th, 2006 at 5:41 pm
MikeB – I agree very much on your points, in my opinion this was the best episode yet, I really got into it and enjoyed learning about House’s feelings and ethics. The whole episode was great to me, and since I know nothing about medicine, I really don’t care if they make every single thing they say up, as long as it is interesting. I cant wait to see next weeks, I think the whole series is just warming up!
November 15th, 2006 at 7:07 pm
Jono- Coma guy asked House if he was ever in love to which he said YES, and he asked where they met. House replies “She shot me”…it was a paint ball game, “Doctors vs Lawyers”. They did not blatantly say it was Stacy but I am assuming it was since she is the love of his life and she is a lawyer. I am hoping they bring her back, she is such a good match for House. It’s nice to see him happy once and a while.
November 15th, 2006 at 10:07 pm
I have no problem with the extremely low grade for the medical stuff. I thought having a guy come out of a 10 year vegetative state like nothing happened was far too much of a stretch.
I don’t necessarily watch House for the medical accuracy. I would appreciate a little more plausibility with the medical aspects, but it won’t be the deal-breaker that makes me stop watching the show.
The soap opera aspects were better, I think. Particularly with House, Wilson and Gabriel. I have no real opinion one way or another on Tritter. Interesting that they both think being ‘right’ is what counts.
November 15th, 2006 at 10:23 pm
I too believe this episode had nice dramatic moments. Finding out why House became a doctor, the father saving the son in such a way, and then the Wilson and Tritter with the team scenes made it really great. I think, because it wasn’t as tense as dramatic situations in the past have been, it may not have been fully appreciated. In other words, if you ask me, this episode is subpar (dramatically) compared to an episode like last season’s “Euphoria” and the other REALLY good ones. I think it was above average on a normal scale, but not extreme because of the delivery. As for medicine, well, this is just the opinion of a kid in High School, but even I could tell the mystery sucked…
November 15th, 2006 at 10:30 pm
As to some of the criticism with regards to coming out of the coma, they did explain that he was moving around during the coma and such was not experiencing the normal muscle atrophy. I’m not saying that explanation is medically accurate, but they did give an explanation, which is a lot more than you can say about the guy in the first episode.
And they never said that the cocktail would wake him up for exactly 25 hours, just that it would last about a day, but could be as much as two.
As for John Larroquette driving and not catching the keys, that was because earlier they said that the cocktail that woke him up also enhanced his reflexes to crazy levels, so his not catching the keys was a sign that he was slipping back into the coma.
November 15th, 2006 at 11:48 pm
Ew, bad bad bad episode. Bad medicine, bad soap opera, bad waste of John Larrouquette’s talents. Just bad.
And how many times, from how many characters’ mouths, do we have to hear someone say, “Your a sad, lonely, festering mess, Dr House. But you’re a righteous dude.” We get it, already. And I agree with those who find the Tritter sub-plot dull and unappealingly, ickily dark. And if I see one more questionable organ transplant episode (brain-dead-sick-lady, hidden-hepatitis-brother, about-to-be-dumped-lover, etc. — are those really That common that they show up several times in any given 22-episode season?), that’s it for me. I’m pulling out my West Wing dvds.
The House series of previous seasons witty, funny, dramatic, sharp, and it just wasn’t remotely believable with this last episode.
Has House jumped the shark?
November 16th, 2006 at 4:48 am
I trust that there were errors with the medicine and liberties taken. But like others here I can’t agree with the grade for the drama. The comedy was great in this episode, we learned a lot about House and others around him, and I really enjoyed the hotel scenes with House, “vegetative state guy,” and Wilson. The suicide thing didn’t quite sit with me, but that was greatly overshadowed by the focus on House this episode, which I thought was terrific.
November 16th, 2006 at 6:45 am
House hasn’t “jumped the shark” (but that phrase sure as hell has :-P) — just look at these boards. The positively antipodal opinions on these boards can be adequately described as CONTROVERSY which is incredibly important. Controversy is what writers strive for. When you see an increasing bipolarization of opinions surrounding a show, it means the show is generating controversy. Which is good. Pissing some people off while pleasing others makes them fight. The more they fight, the more they discuss the show. While some may not have the tolerance for it, most will stick it out just to validate their feelings of angst toward the show.
November 16th, 2006 at 6:48 am
Oops, hit the wrong button before I was done posting. Anyway, I was wrapping up by saying, the more controversy you generate, the more “buzz” you generate around a show, and hence media outlets begin to air stories about the controversy and more people get interested. More people watch just to see what everyone’s talking about, or to try and get a sense of the controversy themselves. You don’t think the writers WANT you to hate Tritter? You don’t think they’re aware of the bizarre medicine going on lately? C’mon, there is a *team* of doctors (yes, real-life MDs) that assemble this show for the writers (who them dramafy it and smooth it out, no I’m not kidding).
November 16th, 2006 at 10:34 am
i’d just like to point out from a legal point of view that it would have been better for house’s case if the young guns didn’t say a word to the detective, the same for wilson – as it is their right not to say a single word to the police.
of course most people don’t know that and people assume they must answer if the police ask questions. the only thing in fact you have to say (if you are arrested) is your name and address.
everything else you can keep inside until court ;)
and the use of their right to silence can’t be used against House, as that breaks the notion of procedural fairness in natural justice.
/2c
November 16th, 2006 at 1:14 pm
Controversy might be good for TV shows, but usually not a controversy about whether or not the writing is awful…
November 16th, 2006 at 2:18 pm
I agree with Keith above that they should have explained how the heck they got the heart through the legal system so quickly. I’d expect there to be a lot of questions from the police like “What the hell were you two doctors doing with the resurrected guy here?”
I didn’t like House’s answer as to why he became a doctor at all.
I don’t know much about medicine, but the miracle drug and miracle temporary revival looked too miraculous.
November 16th, 2006 at 2:30 pm
A while back someone with inside knowledge posted that the original lead writer for the series had departed this season. That would certainly account for the sudden drop in script quality. The studio thinking must be that since this has become an established success, it can coast along on autopilot without a serious drop in ratings. If this is their reasoning it fatally underestimates the intelligence and acuity of the House audience. Except for House I watch nothing but PBS, and if this trend continues, I’ll just delete the season pass from my Tivo and soldier on. The real question is “What program is this guy writing for now?” If this Johnny Appleseed is sowing his golden apples in fresh pastures, that’s where I want to be grazing.
November 16th, 2006 at 2:41 pm
A small quibble with your review… you say “This raises the question whether he would be candidate at all for heart transplant since his kidneys and liver are still in such bad shape.” That question was actually mentioned in the episode, something along the lines of “he’ll never be approved for a transplant because he’s an alcoholic”, which is why the father offers his heart in the first place.
The show hasn’t been up to snuff this season. House’s abrasiveness has been out of character, not written in the same way. The medicine is revving up for that final shark-jumping. The soap opera is taking over, and they’re doing interesting things with House and Wilson, and I really like the story arc with the cop. I have this terrible feeling that they’re going to have the cop get really sick and have House save his life to make everything all nice though…….
November 16th, 2006 at 6:30 pm
Even I could tell the medicine was a bunch of bunk… but I felt that the rest of the episode, the interpersonal scenes were quite good. Maybe I’m in the minority, but I like this string with the forged prescription. No way House is going to jail like that, but we don’t know how bad it’s going to get for Wilson, and what House will do to save him. That being said, there are two things that are bugging me…
House is obviously dependent on painkillers, and I gather that he takes vicodin. He seems to really be taking a lot, and the episode where he forged the prescription, he wrote down 5/500. From what I can gather, he definitely takes quite a bit more than 6 per day, and has been doing it for years. Wouldn’t that amount of acetaminophen be doing some harm to his body, especially someone who is on long term pain management when he would be taking over 4 grams per day?
The other question – I think it was Foreman who mentioned chelation therapy. Is there any difference between their use of it, and the use championed by people in the “alternative medicine” community who recommend it as maintenance for people with big pocketbooks? I’ve read about it and heard that chelation therapy is a bunch of crap, but it also seems like there is a use for it which is legitimate. Can anyone possibly give me a bit of an explanation on the difference (or if the medicine was totally off on chelation therapy in this episode?
I love this website. Dear god I love this website!
November 16th, 2006 at 9:48 pm
I have a medical question that got missed:
Why would strangulation be better for keeping a heart in transplantable condition than severing the spinal cord? I would think the asphyxiation, not to mention the extra adrenaline from a prolonged period of stress, would be worse for the heart.
November 17th, 2006 at 2:55 pm
Chelation therapy is a valid treatment for heavy-metal poisoning. There is no good evidence that it confers any benefit from those not suffering from heavy-metal poisoning, which is where your alternative medicine practitioners come in. There’s a nice article on it at quackwatch: http://www.quackwatch.org/01QuackeryRelatedTopics/chelation.html. Actually, the wikipedia page on chelation therapy is good, too.
November 17th, 2006 at 9:37 pm
I don’t know how much of that Chelation Therapy quackwatch website is true, but I can say for certain that their rebuttal of mechanism 3 is completely wrong. Both Fe2+ and Fe3+ form octahedral (discounting slight distortion) complexes in water and EDTA solutions. Furthermore, iron is a very poor oxidizing agent outside of the body. I may be incorrect for within biological systems, since my bio history is lacking, but I would be slightly worried, as iron is essentially necessary for the transport of oxygen through the body (think heme). This is where heavier metals (mercury, lead, gold, etc.) pose a problem. The organic molecules also responsible for oxygen transport have a much higher affinity for these heavy metals than they do for iron, and thus bond to them very strongly and make it hard to remove them from the body. These compounds can’t carry much oxygen when compared with the iron compound as well.
November 17th, 2006 at 11:36 pm
A question for inquiring minds… anyone notice the “you were right…you did the right thing” theme? Any guess as to what that was in House’s past? The answer may be as interesting as the answer House gave as to why he became a doctor. Yea, the writing has changed. It seems to have polarized us thinkers who are addicted to the show. And, there are no simple answers. But, as House would say…”It’s really cool…”
November 20th, 2006 at 10:44 pm
House is a product of Western society that prizes intellect over emotion. I’m guessing that he had a falling out with his father in the past over something that made sense, but didn’t feel right to the dad. As a result, House lives with a constant feeling of wanting to do the right thing (by his own code of ethics) at whatever the cost… but he still wants that nod of approval from his pop for it. Doing the right thing doesn’t make everyone happy, after all.
I really liked his answer about why he became a doctor. He doesn’t want respect or power, or anything like that. He just wants to balance on that fine line of tolerance so he can get away with doing whatever he wants to do by being the best damn doctor he can be.
November 21st, 2006 at 2:29 pm
Loved the episode. Sp far, definitely the best of the season for me. I love the cop arc because it’s gets at House’s many addictions. I loved the hotel scenes between HL/JL/and RSL.
I only had one question, if JL was losing hif fine motor coordination (couldn’t catch the soda can, how did he get the noose around his neck to strangle himself?
November 21st, 2006 at 10:43 pm
“A question for inquiring minds… anyone notice the “you were right…you did the right thing” theme? Any guess as to what that was in House’s past? The answer may be as interesting as the answer House gave as to why he became a doctor.”
As was mentioned before, House strives to do what is right and to be right. Like he said with the Japanese doctor: it didn’t matter anything else about him when he was right. Wilson says in the episode “Need to Know” that House doesn’t like himself, but he does admire himself. In that same episode, House talks to Mark Warner about how Mark is saying things and hating that he’s saying them. He asks how House got past that, and he says that he didn’t (might be just being himself in saying something to get rid of Mark, but it could also be true). If both are true, it can be that House hates what he does because he doesn’t like who he is (pushing people away, saying the things he does) — yet he does still admire himself because he’s right a lot, eventually, when others are not. So that’s what he strives for. That’s why he asks it of the woman in “Control” before he goes to lie to the transplant committee (”I want to know what’s right”); that’s why even though he’s in serious pain with a migraine headache in “Distractions,” when asked how he is, he laughs, smiles, and says “Yeah, I was right” (also related to why the use of the medication in “Skin Deep” is brought up again after he solved the case — being right is similar, if not stronger, than the vicodin high); that’s why when he thought that he was dying in “Three Stories” he says “I was wrong.”
Like someone else said, House and his dad certainly had a falling out, most likely over this since the reason House gives for hating his father is that he has his “moral compass” that makes it so he doesn’t lie about anything. Something could’ve happened where House lied to do what was truly right, and his dad disapproved but didn’t see it that way. And then it probably became all the more important to him if it wasn’t already.
November 22nd, 2006 at 4:43 pm
Well, Shane, I was just answering someone’s question about chelation. I don’t know if this is the place for it, but I’d say Quackwatch got the right answer for the wrong reason in its rebuttal #3, as all it needs to assert is that EDTA does not reduce the reactivity of the iron. I don’t have the expertise to say which coordinate complex is more reactive, but it seems you agree that iron shouldn’t be a major concern in free-radical formation. You’re right that they unnecessarily go on about insoluble ferric hydroxide which shouldn’t matter in an organic-ligand-rich environment. The fact that both Fe2+ & Fe3+ form octameric complexes is neither here nor there. Indeed, both Fe2+ and Fe3+ are found in hemoglobin, though only Fe2+ is useful (so the Fe3+ is normally reduced to Fe2+).
You imply that other heavy-metals displace the iron of the heme group, which I can’t support. Some heavy metals, such as lead, clearly do prevent heme synthesis as part of their effects, however. Hemoglobin does bind other metals, but doesn’t lose iron in the process. I would expect the reduced capacity from this to be very minor (except in very high metal doses) compared to the effect from interference with heme formation.
December 4th, 2006 at 4:43 pm
I am stunned at how bad this show has gotten so quickly. I could ignore some of the medical ridiculousness and hospital/doctor ridiculousness but when the stories are also junk it’s hopeless. This new story with the police officer is absurd. This would have been stopped instantly. How come the director who is happy to talk lawyers all day long so far has never called one? None of this is legal I would imagine. Where are the subpoenas and hearings etc? And I am tired of the postings I am seeing by people who know nothing about pain who claim that House is just your basic junkie. No one who does not manage pain and is actual primarily that or else who has severe pain knows this stuff. The reality is he would have been put on some better meds and other types of therapy and would not be on Vicodin. I also think the story arc would be tiring in a show like this even though it might be a good one. But this story arc is dreadfully contrived.
December 9th, 2006 at 12:43 am
Um, doesn’t a person have to be *physically* alive (albeit brain-dead, kept alive with machines) in order to donate a heart? You can’t just pull a dead heart out of somebody and put it into someone else, cell death begins immediately after death. There’s no way he could have killed himself and gotten from Atlantic City with a heart still in good enough shape for that.
March 12th, 2007 at 12:07 pm
First, the link “photosensitive epilepsy” in the review is a bad link. “hhttp” causes browsers to choke. It should be “http”. A good arrow to put into your quiver: check your links before you post anything. Otherwise, you have to copy|paste the address into your browser’s address window and take a scalpel to the protocol.
I’ve always heard “photosensitive epilepsy” as flutter vertigo. And, only some who are epileptic suffer from it and some non-epileptics suffer from it as well.
Cheers,
FV
April 21st, 2007 at 9:51 pm
If he is on vicodin after all these years, I assume there must be an in-universe explanation, and the whole pain thing may just be part of the point: Tritter decides House is a dangerous junkie and tries to destroy him for the twin aims of saving society from medical malpractice and gaining retribution for House’s cruelty; he ignores the pain (not having been in incapacitating pain himself), dismissing it as part of withdrawal, unless he realises it’s pain, in which case he could be considered, maybe even in a civil court, to be engaging in torture; he (knowing crooked cops from other shows) tells his superiors that all of House’s mistakes are due to vicodin so that he can enforce the agony, something House would never do unless he had to; he doesn’t want House to use his vicodin responsibly, he wants him not to use it at all; he is probably going to pull every DEA# in the hospital if he needs to to force House to turn to street drugs, and then he’ll tell the court that he was doing this before whenever he couldn’t get his vicodin.
He probably (My eleven-year-old sister knows the train of thought is wrong, admittedly from watching the Simpsons) thinks that if you suffer from being forced to abstain from narcotics, you’re an addict, or (because of the dramatically-misled US public) that he can portray you as one in court.
He isn’t just the mirror-image of House: He’s a symbol of the war on drugs (Any amount of vicodin is too much and any illegal drug use means you have to be locked to protect the public); he’s a symbol of, to paraphrase Vogler, “The problem with the Justice System in America” (Police Officers walking the streets as if being a Police Officer makes the street your own personal fiefdom and acting as if they aren’t accountable to anybody); he’s a symbol of abusive authority venting his wrath on anyone he can with impunity (Cops who think they have a right to cause you agony, lock you up without evidence, search your house and leave it in disarray, or ruin your career, just because they’re a cop, you aren’t, and you or someone close to you needs a drug and they’re unable to quit theirs); he’s a symbol of archaic (though for your edification, House, not to the point of being describable as Neandertal; at least Neandertals performed crude operations to, apparently, relieve painful swelling) Christian moral outrage (People who can’t handle pain on their own have to turn to God drug rehab, not medicine, or they’ll lose their souls ability to do their jobs properly*). Even unintentionally, he shows
* Which for House may as well be his soul, but anyway:
1) Not only is drug rehab not a FDA-approved analgesic, doubts have been raised about its constitutionality. AA (the basis of NA and most “professional” addiction rehab, as evidenced by people who “use a twelve-step process”), and the entire point of AA is the twelve steps and twelve traditions, originated as part of the Oxford Group, a religious group from which it apparently seceded in 1942 because they endorsed a certain Hitler, A (and I don’t mean the Catholic painter famous for both his exceptional adherence to classical norms and his abject refusal to enter politics; pity his father didn’t want him to be an artist) and the AA felt it should remain neutral on everything they could without compromising their mission. Also, Griffin v Coughlin means that in NY, forced AA meetings are religious indoctrination. Besides, it is patently obvious (admitting one is helpless and surrendering oneself to a higher power is a pretty big hint) that it only works for people who accept divine intervention, and if there is anyone concievable who is less suitable than House for this, they’d be physically incapable of being religious.
2) On the Christian bit, it is even more fundamentalist than the position of fundamentalists and thankfully mostly historical (A History of the Warfare of Science with Theology in Christendom, by Andrew Dickson White, online at http://cscs.umich.edu/~crshalizi/White/ has many examples of irrational anti-doctor sentiment that, naturally given the title, held up medical science for a long time)
April 27th, 2007 at 4:44 am
There’s two things I still don’t understand with this episode.
-Since Gabriel took the aspirin instead of hanging, did Gabriel already have a headache or was it induced? I was trying to figure out if it was luck or not.
-What was the whole point with Wilson needing someone to impersonate House to tell him the room number? I just do not get that one at all.
Thought it was kind of funny what House said after giving the car keys to Gabriel. Isn’t that the exact opposite of what actually would happen? Wouldn’t he need rehab to get over delayed reflexes and whatnot?
Heck, I can hardly drive after I wake up in the morning. And that’s just after 6-7 hours. This guy can drive a car after sleeping for 10 years. Too bad Gabriel isn’t alive anymore; I’d like to know his skills!
May 11th, 2007 at 11:37 am
“What was the whole point with Wilson needing someone to impersonate House to tell him the room number? I just do not get that one at all.”
It was for an ad-hoc alibi. He could get that woman to say she saw them both in the casino (of course, he wouldn’t be able to find her minutes later, let alone days).
July 9th, 2007 at 5:27 pm
Hi. Well, first of all, thanks for all your reviews.. for me (I’m 16, almost 17, and not planning to study medicine) they are interesting, mainly because I can understand the show a little bit more (and I’d always been curious trying to figure out if the medicine in this kind of shows is accurate, so having reviews made by a doctor is really cool)
Well, now, I’d like to ask you a question..
I was thinking, and I found the theory of mercury poisoning a little… unbelievable.. because apparently, the guy was in his dad’s factory (where he got poisoned) when he was 12 or even younger (the fire was when he was 12), and his kidney, liver, and heart fail 10 years, or more later… so I wanted to know if that is possible..
Well, thanks, and sorry for my bad english.. I’m not from an english speaking country
November 15th, 2007 at 4:22 pm
Kemp: He took the aspirin because House told him that that action would decrease the probability of his heart getting damaged.
Carlos: The explanation given by the script was that the fact that he was an alcoholic “triggered” the mercury poisoning. He wasn’t drinking when he was a child. Don’t know though if this can actually work with mercury. I know that many poisons stay in your body so it seems reasonable. Or just plausible.
November 15th, 2007 at 4:23 pm
Kemp: He took the aspirin because House told him that that action would decrease the probability of his heart getting damaged.
Carlos: The explanation given by the script was that the fact that he was an alcoholic “triggered” the mercury poisoning. He wasn’t drinking when he was a child. Don’t know though if this can actually work with mercury. I know that many poisons stay in your body so it seems reasonable. Or just plausible.
December 16th, 2007 at 1:00 am
John Larroqette is funny, but really not in a class with the other actors in the episode, which is why his scenes had little energy though much amusement. He couldn’t really convulse his face and body the way a man facing his situation would be. I didn’t even bother to worry about him being so spry after 10 years in bed, just enjoyed the humor.
But David Morse is a full match for Laurie. He was terrifying from the first. Like the shark in Jaws, he’s even more scary when you don’t see him, cause he could appear anywhere to grill you. Mentally, in every scene I anxiously scanned the background scenery for him. Just standing there he oozes… major intimidation. It’s obviously a vendetta, but there is some of that gray area of who’s the good guy or bad guy – does Vitter have moral, not just legal right on his side? But these two seem to portray a struggle between elemental powers. And House has been weakened by the emotional conflict over Stacey (I think that’s a major factor in his increasing aggression), the pain coming back, becoming a cripple again, being shot, etc.,
Still working my way through the series. Hope Vitter slips on a banana.
December 16th, 2007 at 1:06 pm
“And House has been weakened by the emotional conflict over Stacey (I think that’s a major factor in his increasing aggression), the pain coming back, becoming a cripple again, being shot, etc.,”
Quoting myself. H’m, sounds like a real soap opera. And I meant Tritter.
January 16th, 2008 at 8:08 pm
I’m not an MD so I can’t tell if the medicine is off, but for some reason my opinions of the show match the opinions of Scott’s. If the medicine’s bad I didn’t find the show that great, with some conflicts of the good old Drama! Great drama horrible medicine. It just seemed kind of shanty, not right- didn’t feel right, not like the others. I couldn’t follow along the storyline as well which is one reason i love House, It makes the medicine more understandable. I.E. I learned what Ornithine Transcarbamylase Deficiency is, how to spell it, and it’s symptoms!!!
February 25th, 2008 at 1:07 am
Can someone please tell me how they managed to explain how the dad’s heart could survive that entire journey while he was DEAD? They could of maybe removed it in atlantic city and then put it on ice, but he was all in one piece when he arrived in NJ. And besides, wouldn’t the police want to investigate a case of suicide?
July 11th, 2008 at 11:02 am
I have to say that I don’t agree with the rating for the soap opera aspect this week. I know that, coming at it from a medical point of view, that’s probably what you’re most interested in, but I found the scenes with House, Wilson and the father interesting and exciting. I think it was probably my favourite episode so far this season, as it replaced everything that I felt was lacking since the start of season 3.
And as someone else said, the scenes with the cop really make me feel uneasy in my stomach!
By the way, despite disagreeing with your soap rating, I really love your reviews and come to read them after every episode!
August 1st, 2008 at 6:13 am
I’m late to this post, but im re-watching all of house again. the first time i saw this episode, i turned it off at the awakening-from-a-coma scene. it just makes me so mad that television shows always get it so damn wrong, probably because ive had personal experience with it.
when you awake from a coma, the last thing thats on your mind is steak. youre more likely to think, ‘how the hell did i get here?’ once you’re not too disorientated to think. your internal clock does not ‘keep ticking’ either. and you are NOT aware of anything going on around you at all.
also, shouldn’t the coma guy have been on a respirator?
anyway, thanks for these posts, theyre really interesting and i enjoy reading them :)
December 14th, 2008 at 6:04 pm
Saw a repeat of the episode, and it struck me that there is a non-medical error. Though the most amusing part of the episode is probably when Wilson is trying to set an alibi for him and House by clumsily hitting on a married women to go ’swinging’ with him, the very last place one would do that would be in a Casino…both Atlantic City and Las Vegas have thousands of cameras, and they would have located a tape showing that it was not House in the casino, and that Wilson paid off the fake House. That would be very damning in Court on an assisted suicide charge.
December 14th, 2008 at 9:12 pm
I didn’t read everything people have written, but I loved the way Wilson immediately tries to hold the patient down…pretty much the worst thing you can do to someone seizing r/t the risk that they will break a bone…he’d have done better to clear the area and give the guy a pillow…
July 22nd, 2010 at 10:02 am
Sorry if someone else has mentioned this, but I just realised something – the kid seemed surprised and a bit frightened at the start when House moved and ‘disappeared’ etc. Surely he’s had akinetopsia for longer than 10 seconds and is used to things like that? People with akinetopsia even have trouble walking (they can do it, but it takes concentration) and he just strolled in like he was normal. That little thing annoys me.
November 12th, 2010 at 1:40 am
To all the medical junkies.
House’s admission of his former experience in japan was quite the story it shows that despite all the medical knowledge we have, it doesn’t explain any of the results you sometimes get that require a person like House or japanese guy to solve such a problem the world has no right answer for. A case in point where a family took on the hospital to have their father IV injected with high doses of vit C the doctors refused til his case was hopeless and the family got a lawyer to act on their behalf and find the required legal argument then miraculously their father came out of his coma and recovered fully from his illness. True story!
January 15th, 2012 at 12:26 pm
Forget the compatibility of the blood types. Are Gabriel’s organs going to survive the trip from Atlantic City (I’m sure there would be “no” police investigation regarding this suicide, especially with House being so closely monitored by his cop friend) even if they transported the whole corpse? I would love to know.
January 15th, 2012 at 12:28 pm
And, if Wilson eventually got in the car with Gabriel and House… why didn’t he drive himself and save the potential “lie-to-cops-again” situation?
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